Duodenal diverticula perforation due to an impacted bezoar is a rare disease. Surgical treatment is associated with high rates of complications and mortality; therefore, treatment strategies must be carefully decided. Endoscopic treatment offers significant benefits to patients over surgery.

The existence of hypopigmentation such as leucism is the result of inbreeding in isolated populations of wildlife and it is associated with environmental stressors. This anomaly may reduce survival rates. Leucism has been record in wildlife, but overall, it is considered very rare. There have been few records of mantled howler monkeys with leucism in Mexico and Costa Rica, but whole-body leucism in howler monkeys from South America was unknown. In this article, we report for the first-time documented cases of whole-body leucism in young individuals of mantled howler monkeys Alouatta palliata in an isolated remanent of tropical dry forest in southwestern Ecuador known as Cerro Blanco Protective Forest. In total, we found two individuals: a juvenile female and a juvenile male in October 2021. We also include a short report about the observation of two seedlings of Dichapetalum (Dichapetalaceae) showing albinism. The report of howler monkeys with whole-body leucism may be caused by the interaction of two processes: inbreeding because of isolated populations and air pollution with sulphur. Thus, immediate management strategies must be considered to significantly increase connectivity with other populations of howler monkeys and reduce air pollution in Guayaquil. Our findings also reveal that hypopigmentation is becoming more frequent in howler monkey´s population along its distributional range. Therefore, we encourage the community to consider a regional management strategy.

Telomeres, the terminal repetitive DNA sequences at the ends of linear chromosomes, have strong associations with longevity in some major taxa. Longevity has been linked to rate of decline in telomere length in birds and mammals, and absolute telomere length seems to be associated with body mass in mammals. Using a phylogenetic comparative method and 30 species of birds, we examined longevity (reflected by maximum lifespan), absolute telomere length, the rate of change in telomere length (TROC), and body mass (often strongly associated with longevity) to ascertain their degree of association. We divided lifespan into two life-history components, one reflected by body size (measured as body mass), and a component that was statistically independent of body mass. While both lifespan and body mass were strongly associated with a family tree of the species (viz., the phylogeny of the species), telomere measures were not. Telomere length was not significantly associated with longevity or body mass, or our measure of mass-independent lifespan. TROC, however, was strongly associated with mass-independent lifespan, but to a lesser degree with body mass. Our results supported an association of TROC and longevity, in particular longevity that was independent of body size and part of the pace-of-life syndrome of life histories.

Background: Despite the WHO recommendation that pregnant women be prioritised for seasonal influenza vaccination, coverage in the Western Pacific Region remains low. Our goal was to provide additional data for the Western Pacific region about the value of maternal influenza vaccination to pregnant women and their families. Methods: We conducted a 16-year retrospective cohort to evaluate risks associated with influenza-associated maternal acute respiratory infection (ARI) in New Zealand. ARI hospitalisations during the May-September influenza season were identified using select ICD-10-AM primary and secondary discharge codes from chapter J00-J99 (diseases of the respiratory system). Cox proportional hazards models were used to calculate crude and adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Results: We identified 822,391 pregnancies among New Zealand residents between 2003 and 2018; 5,095 (0.6%) had >1 associated ARI hospitalisation during the influenza season; these pregnancies were at greater risk of preterm birth (aHR 1.5, 95% CI 1.3-1.7), and low birthweight (aHR 1.7, 95% CI 1.5-2.0) than pregnancies without such hospitalisations. We did not find an association between maternal ARI hospitalisation and fetal death (aHR 1.1, 95% CI 0.6-1.4) during the influenza season. Maternal influenza vaccination was associated with reduced risk of preterm birth (aHR 0.8, 95% CI 0.7-0.9), and low birthweight (aHR 0.9, 95%CI 0.8-0.9), and fetal death (aHR 0.5%, 95% CI 0.3-0.7). Conclusion: In this population-based cohort, being hospitalised for an ARI during the influenza season while pregnant was a risk-factor for delivering a preterm or a low birthweight infant and vaccination reduced this risk.

Degradation of solid polyethylene terephthalate (PET) by leaf branch compost cutinase (LCC) produces various PET-derived degradation intermediates (DIs), in addition to terephthalic acid (TPA), which is the recyclable terminal product of all PET degradation. Although DIs can also be converted into TPA, in solution, by LCC, the TPA that is obtained through enzymatic degradation of PET, in practice, is always contaminated by DIs. Here, we demonstrate that the primary reason for non-degradation of DIs into TPA in solution is the efficient binding of LCC onto the surface of solid PET. Although such binding enhances the degradation of solid PET, it depletes the surrounding solution of enzyme that could otherwise have converted DIs into TPA. To retain a sub-population of enzyme in solution that would mainly degrade DIs, we introduced mutations to reduce the hydrophobicity of areas surrounding LCC’s active site, with the express intention of reducing LCC’s binding to solid PET. Despite the consequent reduction in invasion and degradation of solid PET, overall levels of production of TPA were ~3.6-fold higher, due to the partitioning of enzyme between solid PET and the surrounding solution, and the consequent heightened production of TPA from DIs. Further, synergy between such mutated LCC (F125L/F243I LCC) and wild-type LCC resulted in even higher yields, and TPA of nearly ~100% purity.

Nervous system involvement in IgG4-related systemic disease (IgG4-RD) is rarely reported and manifests as hypertrophic pachymeningitis and hypophysitis. In this report, a 33-year-old woman with neurological manifestations was diagnosed with IgG4-RD by biopsy. The patient showed improvement in symptoms after the treatment.

POLR3A is a main subunit encoding RNA polymerase III which is involved in transcription of many RNA structures. Here we report a new presentation of c.1771-6C>G intronic variant presenting as developmental regression, seizure and dystonia in a 6-year-old boy associated with striatum involvement in the brain MRI.

Ondansetron is an FDA-approved selective serotonin 5-HT3 receptor commonly indicated as an anti-emetic agent for nausea and vomiting. It is rare to observe fatal reactions from ondansetron despite having no allergies or previous exposure. We report a case of anaphylactoid reaction with spontaneous coronary vasospasms in response to intravenous ondansetron.

I would like to submit an erratum for the article with the title ‘Development of Kinetic Energy Density Functional Using Response Function Defined on the Energy Coordinate’ (Int. J. Quantum Chem. 2022;e26969, https://doi.org/10.1002/qua.26969). The corresponding author of the article is Hideaki Takahashi. The author found an error in producing the graph with the legend ‘OF-DFT’ in Fig. 8 in the article. The error in the graph is attributed to the fact that the atomic response function was spuriously multiplied by 2. We refer the editor to the main text of the erratum in more details. The graph was revised using the amended source code. Fortunately, it was found that the corrected graph was changed favorably as compared to the original one, showing better agreement with the reference calculation.

Pichia pastoris ( Komagataella phaffii) is a fast-growing methylotrophic yeast with the ability to assimilate several carbon sources such as methanol, glucose, or glycerol. It has been shown to have outstanding secretion capability with a variety of heterologous proteins. In previous studies, we engineered P. pastoris to co-express E. coli AppA phytase and the HAC1 transcriptional activator using a bidirectional promoter. Phytase production was characterised in shake flasks and did not reflect industrial conditions. In the present study, phytase expression was explored and optimised using instrumented fermenters in continuous and fed-batch modes. First, the production of phytase was investigated under glucose de-repression in continuous culture at three dilution factors, 0.5 d -1, 1 d -1, and 1.5 d -1. The fermenter parameters of these cultures were used to inform a kinetic model in batch and fed-batch modes for growth and phytase production. The kinetic model developed aided to design the glucose feeding profile of a fed-batch culture. Kinetic model simulations under glucose de-repression and fed-batch conditions identified an optimal phytase productivity at the specific growth rate of 0.041 h -1. Validation of the model simulation with experimental data confirmed the feasibility of the model to predict phytase production in our newly engineered strain. Methanol was used only to induce the expression of phytase at high cell densities. Our results showed that high phytase production required two stages, the first stage used glucose under de-repression conditions to generate biomass while expressing phytase, and stage two used methanol to induce phytase expression. The production of phytase was improved 3.5-fold by methanol induction compared to the expression with glucose alone under de-repression conditions to a final phytase activity of 12.65 MU/L. This final volumetric phytase production represented an approximate 36-fold change compared to the flask fermentations. This two-phase strategy allowed to optimise phytase productivity by producing phytase during both growth and methanol induction phases. Finally, the phytase protein produced was assayed to confirm its molecular weight, and pH and temperature profiles. This study highlights the importance of optimising protein production in P. pastoris when using novel promoters and presents a general approach to performing bioprocess optimisation in this important production host.

Objectives: To understand the epidemiological and clinical characteristics of pediatric SARS-CoV-2 infection during the early stage of Omicron variant outbreak in Shanghai. Study designs: This study included local COVID-19 cases<18 years in Shanghai referred to the exclusively designated hospital by the end of March 2022 since emergence of Omicron epidemic. Clinical data, epidemiological exposure and COVID-19 vaccination status were collected. Relative risks (RR) were calculated to assess the effect of vaccination on symptomatic infection and febrile disease. Results: A total of 376 pediatric cases of COVID-19 (median age:6.0±4.2 years) were referred to the designated hospital during the period of March 7-31, including 257 (68.4%) symptomatic cases and 119 (31.6%) asymptomatic cases. Of the 307 (81.6%) children ≥3 years eligible for COVID-19 vaccination, 110 (40.4%) received 2-dose vaccines and 16 (4.0%) received 1-dose vaccine. The median interval between 2-dose vaccination and infection was 3.5 (IQR: 3, 4.5) months (16 days-7 months). Two-dose COVID-19 vaccination reduced the risks of symptomatic infection and febrile disease by 35%(RR 0.65, 95% CI: 0.53-0.79) and 33% (RR 0.64, 95% CI: 0.51-0.81). Two hundred and sixteen (83.4%) symptomatic cases had fever (mean duration:1.7±1.0.8 days), 104 (40.2%) had cough, 16.4% had transient leukopenia; 307 (81.6%) had an epidemiological exposure in household (69.1%) , school (21.8%) and residential area (8.8%). Conclusion: The surge of pediatric COVID-19 cases and multiple transmission model reflect wide dissemination of Omicron variant in the community. Asymptomatic infection is common among Omicron-infected children. COVID-19 vaccination can offer some protection against symptomatic infection and febrile dise

Belowground life is traditionally considered to rely on leaf litter as the main basal resource, whereas the importance of roots remains little understood, especially in the tropics. Here, we analysed the response of 30 soil animal groups to root trenching and litter removal in rainforest and plantations in Sumatra and found that roots are similarly important to soil fauna as litter. Trenching effects were stronger in soil than in litter with animal abundance being overall decreased by 42% in rainforest and by 30% in plantations. Litter removal little affected animals in soil, but decreased the total abundance by 60% both in rainforest and rubber plantations but not in oil palm plantations. Litter and root effects were explained either by the body size or vertical distribution of specific animal groups. Our findings highlight the importance of root-derived resources for soil animals and quantify principle carbon pathways in tropical soil food webs.

Background Microbiome studies are often limited by a lack of statistical power due to small sample sizes and a large number of features. This problem is exacerbated in correlative studies of multi-omic datasets. Statistical power can be increased by finding and summarizing modules of correlated observations, which is one dimensionality reduction method. Additionally, modules provide biological insight as correlated groups of microbes can have relationships among themselves. Results To address these challenges, we developed SCNIC: Sparse Cooccurrence Network Investigation for compositional data. SCNIC is open-source software that can generate correlation networks and detect and summarize modules of highly correlated features. Modules can be formed using either the Louvain Modularity Maximization (LMM) algorithm or a Shared Minimum Distance algorithm (SMD) that we newly describe here and relate to LMM using simulated data. We applied SCNIC to two published datasets and we achieved increased statistical power and identified microbes that not only differed across groups, but also correlated strongly with each other, suggesting shared environmental drivers or cooperative relationships among them. Conclusions SCNIC provides an easy way to generate correlation networks, identify modules of correlated features and summarize them for downstream statistical analysis. Although SCNIC was designed considering properties of microbiome data, such as compositionality and sparsity, it can be applied to a variety of data types including metabolomics data and used to integrate multiple data types. SCNIC allows for the identification of functional microbial relationships at scale while increasing statistical power through feature reduction.

Sickle cell disease (SCD) requires coordinated, specialized medical care for optimal outcomes. There are no United States (US) guidelines that define a pediatric comprehensive SCD program. We report a modified Delphi consensus-seeking process to determine essential, optimal, and suggested elements of a comprehensive pediatric SCD center. Nineteen pediatric SCD specialists participated from the US. Consensus was predefined as 2/3 agreement on each element’s categorization. Twenty-six elements were considered essential (required for guideline-based SCD care), ten were optimal (recommended but not required), and five were suggested. This work lays the foundation for a formal recognition process of pediatric comprehensive SCD centers.

Herpes simplex encephalitis (HSE) is the most common type of sporadic encephalitis that inflicts high rates of morbidity and mortality. Differentiating a progressing encephalitis syndrome from a lobar hemorrhage as a complication presents a challenge and requires great vigilance and insight on part of the treating physician.

Fibrolipoma is a variant of lipoma that is relatively uncommon in the mouth tissues, especially the attached gingiva. It is diagnosed by histopathologic and immunohistochemistry evaluation and treated by total excision. A case of a patient with attached gingiva fibrolipoma, treated by surgical excision under local anesthesia is reported.

This paper is concerned with nonlinear stability of rarefaction wave to the Cauchy problem for a blood flow model, which describes the motion of blood through axi-symmetric compliant vessels. Inspired by the stability analysis of classical $p$-system, we show the solution of this typical model tends time-asymptotically toward the rarefaction wave under some suitably small conditions and there are more difficulties in the proof due to the appearance of strong nonlinear terms including second-order derivative of $v$ with respect to the spatial variable $x$. The main result is proved by employing the elementary $L^2$ energy methods. This is the first result about nonlinear stability of some nontrivial profiles (i.e., non-constant function patterns) for the blood flow model.

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder. TSC consists of a wide variety of clinical manifestations, with neurological and dermatological symptoms being the most frequent. This study aims to describe the clinical characteristics and management of a pregnant patient incidentally diagnosed with TSC.